EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Lower Extremity Amputation
DC 5160-5167 | 38 CFR § 4.71a DCs 5160-5167; § 3.350(a)(2) SMC-K loss of use of foot |
Lower Extremity Amputation is rated by the U.S. Department of Veterans Affairs under DC 5160-5167 of 38 CFR § 4.71a DCs 5160-5167; § 3.350(a)(2) SMC-K loss of use of foot across 3 severity tiers (40%+ -- Severe limitation or ankylosis / 20% -- Moderate limitation / 10% -- Mild limitation or painful motion). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303. This condition is frequently rated as secondary to Lumbar Spine Condition or Hip Condition - Contralateral under 38 C.F.R. § 3.310.
OVERVIEW
Surgical or traumatic loss of part or all of a lower extremity (toe, foot, leg, hip). Anatomic-level specific canonicals — leg-amputation-above-knee (DC 5161), leg-amputation-below-knee (DC 5164), great-toe-amputation (DC 5171), forefoot-amputation (DC 5166), toe-amputation-multiple — carry the full rating tiers. This record covers cross-cutting concerns (phantom limb pain, prosthesis-fitting issues, contralateral overuse arthropathy, opioid dependence from chronic pain) that apply regardless of amputation level.
RATING CRITERIA (3 LEVELS)
40%+ -- Severe limitation or ankylosis
Severe limitation of motion or ankylosis of the affected joint. Specific percentages depend on the joint and whether dominant/non-dominant.
20% -- Moderate limitation
Moderate limitation of motion with significant functional impairment. DeLuca factors may increase the effective rating.
10% -- Mild limitation or painful motion
Mild limitation of motion, or X-ray evidence of arthritis with painful motion under DC 5003.
KEY EVIDENCE TO GATHER
-Service treatment records showing injury or complaints
-Imaging (X-ray, MRI, CT)
-Range of motion measurements
-Flare-up documentation per Sharp v. Shulkin
-Buddy statements describing limitations
-Prescription history
-Physical therapy records
-Employment impact documentation
SECONDARY CONDITIONS (9 MAPPED)
DC
Altered gait with prosthesis stresses spine
DC
Increased stress on remaining limb
DC
Overuse of remaining leg
DC
Neurological pain in missing limb
DC
Stump pain from prosthesis use
DC
Adjustment to limb loss and disability
DC
Trauma from injury event
DC
Prosthetic socket causes skin issues
DC
Crutch or assistive device use
C&P EXAM TIPS (6)
1.Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.
2.Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.
3.Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.
4.Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).
5.If you use assistive devices (brace, cane), bring them.
6.Describe daily activity impact: work, sleep, household tasks.
SOURCES & EDITORIAL
Rating criteria reference 38 C.F.R. Part 4 (Schedule for Rating Disabilities). This entry has not yet undergone editorial review against the live regulation text — consult the authoritative source directly before relying on the criteria shown.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026